Provider Demographics
NPI:1720075989
Name:SEPICH, RODNEY M (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:M
Last Name:SEPICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2134 SANDY DR STE 16
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2292
Mailing Address - Country:US
Mailing Address - Phone:814-272-5805
Mailing Address - Fax:814-272-0110
Practice Address - Street 1:2134 SANDY DR STE 16
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2292
Practice Address - Country:US
Practice Address - Phone:814-272-5805
Practice Address - Fax:814-272-0110
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD049655-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00179409OtherRAILROAD MEDICARE
PA50042429OtherCAPITAL BC/BS
PA001404211Medicaid
PA736129OtherHIGHMARK BC/BS
PA89484OtherGEISINGER
PA736129OtherHIGHMARK BC/BS
PA50042429OtherCAPITAL BC/BS